Organization
DR. VAMSEEN JETTI PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
VAMSEEN JETTI MD (OWNER)
(202) 505-3884
Entity
Organization
Contact information
Practice address
6200 W PARKER RD, PLANO, TX 75093-8185
(972) 668-7460
(972) 668-7467
Mailing address
3610 GILLESPIE ST, #3, DALLAS, TX 75219-4839
(202) 505-3884
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
P6981
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
P6981
LICENSE
TX
Enumeration date
12/18/2013
Last updated
12/18/2013
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